Overview
Seek emergency care immediately if your child has any red-flag symptoms.
Home observation may be appropriate only if the child is alert, behaving normally, and has no red flags.
If you are worried at any point, medical evaluation is appropriate.
Emergency Warning Signs (Go to the ER Now)
Seek emergency medical care immediately if a child shows any of the following after a head injury:
- Loss of consciousness, even briefly
- Seizures or convulsions
- Repeated vomiting
- Severe or worsening headache
- Confusion, disorientation, or unusual behavior
- Difficulty walking, standing, or coordinating movements
- Weakness in an arm or leg
- Vision problems, unequal pupil size, or double vision
- Slurred or unclear speech
- Excessive sleepiness or difficulty waking
- Blood or clear fluid coming from the nose or ears
These symptoms are consistently identified in pediatric medical guidance as signs of a potentially serious head injury that requires urgent evaluation.
What to Do Right Away for a Mild Head Injury
If your child is alert, interacting normally, and has no emergency symptoms:
- Stay calm and comfort your child.
- Check the head and scalp for swelling, bruising, or cuts.
- Apply a cold pack (wrapped in a cloth) to help reduce swelling.
- Observe your child closely over time.
Medical guidance supports home observation for children with mild head injuries, provided no red-flag symptoms develop.
Monitoring After the Injury (First 24–48 Hours)
Some symptoms of head injury may appear hours or days later. Medical sources recommend continued observation after a head injury, especially during the first 24–48 hours.
Contact a healthcare provider if you notice:
- Increasing sleepiness or lethargy
- New or worsening vomiting
- Persistent headache
- Changes in balance, coordination, or speech
- Mood or behavior changes
- Symptoms that worsen instead of improving
Sleep After a Head Injury
High-quality medical guidance indicates that it is usually safe for children to sleep after a mild head injury.
Seek medical care immediately if a child is:
- Difficult to wake
- Confused upon waking
- Showing any new or worsening symptoms
Some children may be advised by a clinician to have periodic checks during sleep, depending on symptoms.
Types of Head Injuries in Children
Medical sources describe several categories:
- Mild head injury: The child remains alert, interacts normally, and symptoms improve over time.
- Concussion: A mild traumatic brain injury that can involve headache, nausea or vomiting, sensitivity to light or noise, balance problems, or behavior changes.
- More serious head injuries: May involve skull fractures, bleeding, or brain injury and are often associated with red-flag symptoms.
Only a qualified healthcare professional can determine the type and severity of a head injury.
When to See a Doctor vs. When to Go to the ER
Contact a healthcare provider if:
- You are worried about your child’s symptoms.
- New symptoms appear.
- Symptoms worsen or do not improve.
Go to the emergency department immediately if:
- Any red-flag symptoms are present.
- Symptoms worsen rapidly.
- Your child becomes hard to wake or unresponsive.
Tests a Clinician May Use
Depending on symptoms and risk factors, healthcare providers may:
- Perform a physical examination.
- Monitor the child over time.
- Order imaging tests (such as CT scans) when clinically indicated.
There is no high-quality evidence that imaging is needed for every head injury; decisions are based on specific risk factors.
Preventing Future Head Injuries
Evidence-based injury-prevention strategies include:
- Using safety gates on stairs.
- Supervising children on elevated surfaces.
- Using helmets for age-appropriate activities like biking or riding scooters.
- Ensuring proper use of car seats and seat belts.
These measures reduce risk but cannot eliminate all head injuries.
Frequently Asked Questions
When should I worry about a toddler head injury?
You should seek medical care if your child shows emergency warning signs or if you are concerned about their symptoms.
When should I take my toddler to the ER?
Emergency care is recommended for symptoms such as loss of consciousness, seizures, repeated vomiting, severe headache, confusion, or difficulty waking.
What should I do if my child hits their head but does not pass out?
Comfort your child, apply a cold pack for swelling, and observe closely. Seek medical care if symptoms develop or worsen.
My toddler fell and hit the back of their head — is that worse?
There is no high-quality evidence that injury location alone predicts severity. Medical guidance emphasizes symptoms and clinical signs rather than impact location.
How long should I monitor my child after a head injury?
Medical guidance supports monitoring, especially during the first 24–48 hours, because some symptoms may appear later.
Is a scalp bump (“goose egg”) dangerous?
There is no high-quality evidence showing that a scalp bump alone indicates serious injury. Medical evaluation is based on symptoms and overall condition.
Can I give pain medication after a head injury?
There is no high-quality evidence supporting or opposing routine pain medication use after a head injury without clinician guidance. Follow advice from a healthcare professional.
APA Reference List
Centers for Disease Control and Prevention. (2025, September 15). Signs and symptoms of concussion. CDC HEADS UP. https://www.cdc.gov/heads-up/signs-symptoms/index.html
Johns Hopkins Medicine. (n.d.). Head injury in children. https://www.hopkinsmedicine.org/health/conditions-and-diseases/head-injury-in-children
Kuppermann, N., Holmes, J. F., Dayan, P. S., Hoyle, J. D., Jr., Atabaki, S. M., Holubkov, R., Nadel, F. M., Monroe, D., Stanley, R. M., Borgialli, D. A., Badawy, M. K., Schunk, J. E., Quayle, K. S., Mahajan, P., Lichenstein, R., Lillis, K. A., Tunik, M. G., Jacobs, E. S., Callahan, J. M., … Pediatric Emergency Care Applied Research Network (PECARN). (2009). Identification of children at very low risk of clinically-important brain injuries after head trauma: A prospective cohort study. The Lancet, 374(9696), 1160–1170. https://doi.org/10.1016/S0140-6736(09)61558-0
Lurie Children’s Hospital. (2025, March 17). What to do if a child hits their head. https://www.luriechildrens.org/en/blog/what-to-do-if-a-child-hits-their-head/
National Health Service. (n.d.). Head injury and concussion. https://www.nhs.uk/conditions/head-injury-and-concussion/
NHS inform. (2025, April 29). Minor head injury. https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/minor-head-injury/
National Institute for Health and Care Excellence. (2023, May 18). Head injury: Assessment and early management (NICE guideline NG232). https://www.nice.org.uk/guidance/ng232
National Institute for Health and Care Excellence. (2023, May 18). Head injury: Assessment and early management—Recommendations (NICE guideline NG232). https://www.nice.org.uk/guidance/ng232/chapter/recommendations
Royal Children’s Hospital Melbourne. (n.d.). Head injury – general advice. Kids Health Info. https://www.rch.org.au/kidsinfo/fact_sheets/head_injury/
Royal Hospital for Children (NHS Greater Glasgow and Clyde). (2025, October 31). Injuries: Head injury. https://rhc.nhsggc.org.uk/royal-hospital-for-children-for-patients-carers-visitors/about-your-childs-health-information-resources/concerned-about-accidents-and-injuries/injuries-head-injury/
HealthyChildren.org. (2024, December 10). Head injury in children: How to know if it’s minor or serious. American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Head-Injury.aspx